A CASE OF ABDOMINAL APOPLEXY, THE BLEEDING POINT CONFIRMED BY ANGIOGRAPHY

In the category of nontraumatic abdominal bleeding, abdominal apoplexy is a rare condition. The preoperative diagnosis of this lesion is fairly difficult, and, in most cases, spontaneous ruptures of branches of abdominal arteries are found. Aneurysms and fragility of the arterial wall were pointed out as the cause of this con-dition. Recently, we experienced a patient in whom the site of bleeding of the abdominal apoplexy was verified by angiography. A 62-year-old man, complained of abdominal pain and fullness after hypotensive transient unconsciousness. He was suspected of having appendicitis and underwent laparotomy. Massive bleeding in the abdominal cavity was found, but the bleeding site was not confirmed. Bleeding seemed to be stopped, and a sump drain was placed under careful observation. At seven hours after the operation, rebleeding occurred, and emergency angiography was performed. The bleeding site was confirmed at the area of the left gastric artery and successful surgical treatment was under taken.